| NPI | 1952059610 |
|---|---|
| Former Name | REBECCA SUE GANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-03-12 |
| Last Update Date | 2022-03-30 |